title: Changes of gait pattern in children with Charcot-Marie-Tooth disease type 1A: a 18 months follow-up study.
abstract: BACKGROUND
  In a previous study we identified 3 different gait patterns in a group of children with CMT1A disease: Normal-like (NL), Foot-drop (FD), Foot-drop and Push-off Deficit (FD&POD). Goal of the present study was to perform a follow-up evaluation of the same group of patients to analyze possible changes of gait features in relation to disease progression or specific therapy.
  
  
  METHODS
  Nineteen children with CMT1A were evaluated clinically (CMT-Examination Score and Overall Neuropathy Limitation Scale) and through gait analysis 18.2±1.5 months after a baseline evaluation. Meanwhile, 3 of them had foot surgery.
  
  
  RESULTS
  Fifteen out of the 16 non-operated patients significantly changed at least one of the two parameters associated to primary signs (FD and/or POD). Eleven participants worsened at least one parameter and 9 improved one parameter. CMTES significantly worsened for the group of non-operated patients. However, there was no change in CMTES score in 4 patients and in ONLS score in 11. At subgroup level, participants originally belonging to NL group showed a trend towards a foot-drop deficit (-15%, ns); FD and FD&POD subgroups did not change their primary signs, although significant changes were identified individually. All 3 patients operated have improved push-off and proximal joint patterns during walking. Clinical scores did not change within any sub-group.
  
  
  CONCLUSIONS
  Subtle changes occurring in 1.5 year in gait features of CMT1A children can be instrumentally identified. Such changes show a large inter-subject variability, with some patients even improving their walking pattern. There is anecdotal evidence that foot surgery may improve the push-off phase of gait.
authors.affiliation: Biomedical Technology Department, Don Carlo Gnocchi Foundation Onlus IRCCS, Milan, Italy. mferrarin@dongnocchi.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Ferrarin
authors.forename: Tiziana
authors.initials: T
authors.lastname: Lencioni
authors.forename: Marco
authors.initials: M
authors.lastname: Rabuffetti
authors.forename: Isabella
authors.initials: I
authors.lastname: Moroni
authors.forename: Emanuela
authors.initials: E
authors.lastname: Pagliano
authors.forename: Davide
authors.initials: D
authors.lastname: Pareyson
mesh_terms: D002607:Charcot-Marie-Tooth Disease / Q000150:complications*; D002648:Child; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000209:etiology*; D006801:Humans; D008297:Male